The nurse plans care to prevent a dangerous thermal environment for an older adult client who lives in a northern climate of the United States. Which client assessment data does the nurse recognize that can contribute to the risk of hypothermia? (Select all that apply.)
Has a history of alcohol abuse
Bathes three to four times a week
Has a history of diabetes mellitus
Becomes diaphoretic on warm days
is prescribed antidepressant
Has a history of a cerebrovascular accident CVA
Correct Answer : A,C,D,F
A. Has a history of alcohol abuse
Explanation: Alcohol can contribute to hypothermia as it causes vasodilation, leading to heat loss. It can impair the body's ability to regulate temperature.
B. Bathes three to four times a week
Explanation: While personal hygiene is important, the frequency of bathing alone may not be a direct risk factor for hypothermia. The overall environmental temperature and the individual's ability to regulate their body temperature are more critical considerations.
C. Has a history of diabetes mellitus
Explanation: Diabetes mellitus can increase the risk of hypothermia as it may affect circulation and peripheral nerve function. Impaired sensation and reduced blood flow can contribute to difficulty in maintaining body temperature.
D. Becomes diaphoretic on warm days
Explanation: Excessive sweating (diaphoresis) can contribute to the risk of hypothermia, as it leads to moisture loss from the skin, making it more challenging for the body to maintain a stable temperature.
E. Is prescribed antidepressant
Explanation: While certain medications, including some antidepressants, can affect thermoregulation, the prescription of an antidepressant alone does not necessarily indicate an increased risk of hypothermia. It is essential to consider the specific medication and its potential side effects.
F. Has a history of a cerebrovascular accident (CVA)
Explanation: Individuals with a history of a cerebrovascular accident may have impaired thermoregulation due to damage to the central nervous system. This can increase susceptibility to temperature extremes.
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Related Questions
Correct Answer is C
Explanation
A. Because a conservatorship is the least restrictive alternative, a court hearing is not required.
Explanation: This statement is not accurate. Conservatorships are legal arrangements that involve the appointment of a conservator to manage the financial affairs and assets of an individual who is unable to do so themselves. While conservatorships may be necessary for the protection of the individual, they are not automatically considered the least restrictive alternative, and a court hearing is typically required to establish one.
B. The most legally restricting way individuals and property can be handled are through conservatorships and guardianships.
Explanation: This statement is partially true. Conservatorships and guardianships are legal mechanisms that grant authority to individuals (conservators and guardians, respectively) to manage the affairs of someone who is unable to do so themselves. While they involve legal restrictions, whether they are the most restrictive or not can depend on the specific details of the arrangement and the jurisdiction.
C. A conservatorship entails control over property, whereas a guardianship entails control over the person.
Explanation: This statement is true. In general, a conservatorship focuses on managing the financial affairs and assets of an individual, while a guardianship involves decision-making authority over personal and healthcare matters. The roles and responsibilities of conservators and guardians may vary by jurisdiction, but the distinction between control over property and control over the person is a common principle.
D. Conservators cannot be members of the conservatee's (client's) family.
Explanation: This statement is not universally true. In many cases, family members can be appointed as conservators. The court will typically consider the best interests of the individual in need of protection when appointing a conservator, and a family member may be deemed suitable if they can fulfill the responsibilities of the role. The specific rules regarding who can be a conservator may vary by jurisdiction.
Correct Answer is B
Explanation
A. Encouraging the client to use a cane when ambulating is a positive preventive measure, promoting stability and support during walking.
B. Keeping the side rails up on the client's bed at night can be concerning.
While it might seem like a safety measure, using side rails can lead to entrapment or falls, especially for frail older adults. Side rails can create a false sense of security, and if the client tries to climb over them or gets caught between the rails, it can result in injury.
C. Keeping several low wattage night lights on in the evening is a good preventive measure, as it helps improve visibility and reduces the risk of falls during nighttime activities.
D. Installing wooden railings on the stairway to the bathroom is a positive preventive measure, enhancing stability and support during stair navigation.
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